How sleep restriction helped Dave fall asleep faster, spend less time awake during the night, and get more sleep (#15)

Transcript

Martin Reed:
Welcome to the Insomnia Coach Podcast. My name is Martin Reed. I believe that nobody needs to live with chronic insomnia and that evidence-based cognitive and behavioral techniques can help you enjoy better sleep for the rest of your life.

Martin Reed:
The content of this podcast is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. The statements and opinions expressed by guests are their own and are not necessarily endorsed by Insomnia Coach LLC. All content is provided “as is” and without warranties, either express or implied.

Martin Reed:
Okay, so Dave thank you so much for taking the time to come on to the Insomnia Coach Podcast today.

Dave Barrie:
Excellent, it’s a pleasure.

Martin Reed:
So, let’s start at the beginning. Can you tell us when your sleep problems began and do you have any recollection or any memory of what initially triggered these sleep issues that you dealt with?

Dave Barrie:
Yeah, I’ve been thinking about that and it’s not one single event. I’ve always been sort an anxious sort of person and had trouble falling asleep and staying asleep. I think it came to a head when I had children and children really messed with my sleep. Children were the worst thing for sleep. But when it really became a problem for me was when I had a trip to Canada and I remember every time I’d have a cold or a flu I’d take those flu drugs that would help me sleep at night. And I’d take those and I’d have a fantastic night’s sleep. But then the next night I’d be awake and I couldn’t sleep properly.

Dave Barrie:
So I saw some drugs over the counter in Canada and I took those to try and get a good night’s sleep. And then they gave me a great night’s sleep but after three or four nights of taking them and then going off them, then I found that my sleep drive just absolutely just diminished and I needed those drugs to get that feeling of sleepiness again. But that’s where it really sort of came to a head. Once I started taking that sleep medication, that just eroded my sleep drive completely and made it so hard to get to sleep at night.

Martin Reed:
So you mentioned sleep drive so this makes me think that your issues were primarily with that first hurdle, falling asleep at the start of the night. Was that the main struggle that you were experiencing?

Dave Barrie:
That was the first main struggle that I had but then it came to sleep maintenance insomnia, I’d wake at three o’clock in the morning and I’d look at the clock and think, “Okay, three o’clock in the morning.” It used to be a positive feeling, I used to think, “Three o’clock in the morning, I’ve got another three hours sleep.” And I’d roll over and go back to sleep. But now it was I’d look at the clock and go, “Three o’clock. I’m going to be awake until six, seven o’clock until I get out of bed.” And I was just getting more and more frustrated and not sleeping. And then it’d get to two o’clock and then it’d get to one o’clock and I’d end up having two hours’ sleep or three hours’ sleep and that was it for the night.

Martin Reed:
Yeah, it’s really interesting you say that about the clock watching. How before you really spent much time thinking or worrying about sleep, if you check the time during the night and it was 3:00 AM you’d be, “Oh, great. I’ve got a few more hours left.” But then your mindset just changes once you’re living with that struggle, right? You check the time and if it’s 3:00 AM instead of thinking, “Oh, great. I’ve got a few more hours left.” You’re Like, “Oh, no, I’ve only got a few more hours left.” Your mindset changes even though nothing else has changed.

Dave Barrie:
That’s right, that’s right, yeah.

Martin Reed:
So yeah, I typically suggest to people that are struggling with sleep just stop checking the clock because it never leads to a positive outcome when you’re struggling with sleep. It only has the potential for a negative reaction, which it then ends up making sleep more difficult. I mean is that something you’ve tried? Just not checking the time during the night and not checking the clock?

Dave Barrie:
It’s something that I do religiously now. I make sure if I get up at night like I might go to the bathroom or something, but I come back… My wife’s got one of those little alarm clocks by the bed and I make sure that I never, ever look at that. And it’s working at the moment. It’s really, really working.

Martin Reed:
Yeah, it’s such a small thing but I think it can make just such a big impact and when I tell people about it, they’re kind of like, “Well, how can such a small thing have an impact? I don’t think it’s going to make much difference.” Or they’ll say something like, “Well, the idea of not checking the clock makes me feel kind of anxious. So I just say, “Well, just give yourself an experiment. Just try it for a week or maybe two weeks and just not check the clock once you go to bed until your alarm goes off and just see what kind of effect it has.” And overwhelmingly people find it so helpful.

Dave Barrie:
Yeah, it is.

Martin Reed:
So, you told me you felt that perhaps you were someone that often struggled with sleep in the past. Then it kind of came to a head when you went overseas when you went to Canada. But I thought that was interesting because it kind of follows this very common or familiar mold when it comes to the development of insomnia. By that I mean for many people with insomnia they are kind of like more predisposed to these sleep issues. So if you imagine that there’s this bar and once you go above that bar that’s when you’re struggling with sleep. And some people are just a bit more predisposed so they start off a little bit higher to that bar. So this could be due to anything. You could have a stressful job, more reactive to stress, you might be a strong morning person or a strong night owl. But just kind of from the start you’re a little bit closer to that bar.

Martin Reed:
But then you have this… This model that I’m describing is called the 3-P Model in insomnia, then what happens is we have this precipitating event, which is like the second P in the model. And for you, it sounds like that was that trip to Canada and that’s what kind of pushed you over the bar and led to this sleep disruption, this very noticeable sleep disruption. And often that leads us onto this third and final P in this 3-P model for insomnia which is the perpetuating factors.

Martin Reed:
So instead of sleep just recovering by itself, it’s perpetuated by our response to this sleep disruption, which is often quite understandable and normal and to be expected. When we travel that’s often a time when some of us will struggle with sleep because it’s just a big change, a big environmental change, our senses are bombarded with all these new experiences. But these perpetuating factors make it difficult for our sleep to recover and they can be things like seeking out that over the counter medication, maybe going to bed earlier, staying in bed later, and maybe trying to conserve during the day, canceling plans with friends. All these things that we do in response to that initial sleep disruption and in a bid to improve our sleep it actually kind of backfires and perpetuates the problem. And I just think it’s important to talk about that just because you seem to fit that mold almost perfectly. Do you recognize that just as I was talking?

Dave Barrie:
Yes, definitely, yes.

Martin Reed:
And all these perpetuating factors, they lead to this disruption. Like the sleep drive disruption that you noticed yourself. As soon as you stop taking those over the counter medications you notice that disruption to your sleep drive where there wasn’t that sleepiness present anymore. Other people notice there’s like this body clock disruption where when we get up at all different times of the day, our body doesn’t really know if it should be awake or asleep and that makes the problem more difficult. And then we just trigger a lot of arousal like anxiety and worry and catastrophizing real concern. And, of course, that makes sleep more difficult and further perpetuates the problem. And this is the real challenge that we have with insomnia is getting the sleep drive back on track, getting the body clock back on track, and dealing with that arousal and that anxiety.

Dave Barrie:
Yeah, definitely. I can see that was the start of my problems. Then I started doing the internet searches and talking to people. I was doing a lot of exercise at that time and a lot of people were telling me that you need to get the eight hours sleep and I wasn’t getting the eight hours sleep and that was getting me more frustrated. And my wife was getting worse sleep because I’d wake up, look at the clock and I’d toss and turn and complain and it’d wake her up. It was just landsliding, everything was just making things worse and I can see that now but at the time I couldn’t step away from it, and then I’d look back at it.

Martin Reed:
Yeah, and it’s completely natural as well to have that response because you’re experiencing this concern, this distress with your sleep so you want to pay attention to it and help improve your sleep. So by absolutely no fault of your own, you did everything that comes naturally to you. You were problem solving, you were trying to implement behaviors and techniques to improve your sleep. But, unfortunately, all those sleep efforts that we call them, they actually make sleep more difficult and that’s the strange thing about sleep. And I say this a lot, is so much of our success in life is down to effort. The more effort generally we put into something, the better the outcome.

Martin Reed:
But sleep is completely the opposite. The more effort we put into sleep, the more difficult sleep becomes. And this is a real problem because when we’ve gone through life knowing that effort equals success. When we experience sleep disruption we put effort in and it doesn’t lead to success and that leads to more worry because now were completely lost at sea and we feel like there’s something uniquely wrong with us like maybe we’ve lost the ability to sleep, or that we’re never going to get better.

Martin Reed:
So you mentioned that you tried these over the counter medications. Was there anything else that you tried before you found Cognitive Behavioral Therapy for Insomnia, the CBT-I techniques, which we’ll talk about in a little bit.

Dave Barrie:
Yeah, I tried pretty much everything. I did the sleep hygiene, I think anybody who’s got insomnia has tried the sleep hygiene and sleep hygiene you try to tweak little things here and there but I don’t think it made that much difference at all. But I did meditation and mindfulness and that seemed to help a lot. It didn’t help to get to sleep but when I woke in the middle of the night I’d lay in bed and do the… I think it’s the four, five, seven, eight breathing technique and that used to calm me down and I could lay there and I’d get out of bed I wouldn’t wake in the bed. But I’d get out of bed at six o’clock and I’d feel rested.

Dave Barrie:
I was still getting through the day and I was still feeling great but if my wife asked me that question that everybody asks every morning is like, “Oh, how you’d sleep?” She ended up not asking that question because of the bad responses she got from me. I’d say, “Yes, it was horrible. I had about two hours sleep and I don’t know how I’m going to get through the day.” But an hour into the day and I was fine. But once that sun went down about six o’clock I could feel I was getting tired but by the time it came to bed, I was so stressed that the sleep drive had gone. My mind was ticking over and I couldn’t get to sleep at that time.

Martin Reed:
I think that’s something that a lot of people listening to this are going to relate to. As the evening starts you recognize those sleepiness cues and you probably think in your head, “Oh, if I went to bed now I’d be fine, I’ll go straight to sleep.” But then as your actual bedtime approaches or even just when you get into bed you suddenly feel wide awake again. And that’s commonly this symptom of this conditioned arousal. So basically because so many times you’ve gone to bed and struggled, you’ve been wide awake, you’ve been worried, anxious, frustrated, and because that’s happened over and over and over again you’ve kind of learned that that is what happens when you get into bed.

Martin Reed:
So when you’re not in bed and you know you’re not going to be going to bed soon you are pretty relaxed and so you feel sleepy. But then once that bedtime approaches or you get into bed your brain is all of a sudden preparing for that awful night to come because that’s what it’s expecting because it’s experienced it over and over and over again. So I think a lot of people are going to relate to that.

Dave Barrie:
Yeah, and I had sleep maintenance insomnia for about two years and you think that’s it, this is my life. I wake up at three o’clock in the morning, two o’clock in the morning, and I lie there until it’s time to get out of bed. And you think, well you sort of resign yourself to that’s it. But it wasn’t until I found those techniques and it was a game-changer, it was amazing.

Martin Reed:
So let’s talk about that. So you mentioned what almost everyone does when you have sleep issues you go online and typically you find out about sleep hygiene, which isn’t helpful actually for people with chronic insomnia and we actually know that. People with insomnia don’t always know it but people that work in the field of sleep know it and sadly the people that are doing clinical studies and research, they actually give sleep hygiene to the control group because they recognized it as a nonintervention. It’s something that we know doesn’t work, so when we’re trying to look at how effective different treatments are we give the control group sleep hygiene because we know it doesn’t work.

Martin Reed:
But yet it’s the first thing that is often recommended to people with insomnia and I think that’s so unhelpful because then, of course, it’s another thing that you try and it’s another thing that doesn’t work. And then you just have more worry because you’re like, “This didn’t work for me and everyone is recommending it. There’s definitely something uniquely wrong with me here.” And it just leads to more worry.

Martin Reed:
So you… When was it? I think it was seven months ago, yeah about seven months ago you found the Insomnia Coach website, you found me and you found out about Cognitive Behavioral Therapy for Insomnia, these CBT-I techniques that we talk a lot about on the podcast here. Had you heard about CBT-I before you found my website or was this something that was completely new to you?

Dave Barrie:
No, it was completely new to me. I’d done a lot of searches and I thought I had exercised based insomnia and all these other things I sort of self-diagnosed myself and I was wrong. But when I came across your website I tried the… You offered the 14 day emailing and it was sober, it put my mind at ease. And then I did the sleep diary, which was another great tool. Doing the sleep diary highlighted how bad my sleep was but the sleep diary did get me clock watching a lot more. And the clock watching sort of negated the sleep diary. I needed to…

Dave Barrie:
I think on one of your podcasts a woman would play music and know that the track was 15 minutes long so she’d get out of bed. So I should have done something like that. Instead, I’d look at the clock and then go, “Oh, another 10 minutes and I can get out of bed.” I’d look at the clock again and I’d go, “It’s another five minutes. I’m not going to get any sleep tonight.” And that’d get me more frustrated. So that, for me, it was a negative thing just looking at a clock so much.

Martin Reed:
Yeah, I think it’s really important with that sleep diary to recognize that we don’t want you to be clock watching when you’re filling out a sleep diary or a sleep journal, sleep log, whatever you want to call it. The only time we need you to check the clock when you’re filling out the sleep diary is when you go to bed, just write down the time you go to bed. And then when you get out of bed in the morning and start the day. Everything else should just be estimates.

Martin Reed:
But I totally get that it can really increase that temptation to check the clock because you just want to be so accurate when feeling out the sleep diary. But really we’re just looking for your estimates, your subjective experience, like how long you think you spent awake during the night, for example. How long you think it took you to fall asleep because really that’s all that matters because sleep is just so subjective because someone could get seven hours of sleep and feel great. Someone could get six hours of sleep and feel great, someone could get nine hours of sleep and feel terrible.

Martin Reed:
So the numbers really don’t matter, it’s just how you feel. And so even if you think that you’re really bad at estimating time, you might be, but the way we estimate time tends not to change over time. So it’s still really helpful in terms of tracking trends and progress. And just kind of… It’s almost like a form of accountability in a way as well. If you’re targeting this consistent out of bed time in the morning, just taking those few minutes in the morning to just write down, “Yes, I did get out of bed at 6:00 in the morning.” And I think you touched upon that, it kind of highlighted these potential areas of improvement for yourself when you first got going with that.

Dave Barrie:
Yep, I feel-

Martin Reed:
Go ahead.

Dave Barrie:
I should get back and try the sleep diary again but do it properly this time and not clock watch and just go by the feeling of how you feel in the morning, are you ready to face the day? Do you feel okay? Have you had enough quality… It’s not quantity of sleep, it’s quality of sleep. If you’ve had good quality sleep, then yeah, you can face the day. But that eight hour myth was totally throwing me off when I was first doing it. I thought, “Oh, I have to get eight hours of sleep.”

Dave Barrie:
And I was not getting, without drugs, I could not get near that eight hours of sleep. And even with medication, you get the eight hours but you still felt groggy and drowsy the next day. I could get six or seven hours sleep without the medication and you’d feel so much better like you got better quality sleep and that sleep drive had kicked in and you’re okay for the day. I remember talking to people at my work, they knew that I had some insomnia, they’d ask me how did I sleep and I’d say, “Oh, I got about two hours but that’s all I need. I’ve evolved into the next generation of people, I don’t need sleep anymore.”

Martin Reed:
Yeah, that whole eight hours thing, this pressure that we can put ourselves under to get a certain amount of sleep is a real problem. The number of people that actually need eight hours I think is pretty minuscule. Very few people regularly get eight hours of sleep. I think when we look at actually the averages it’s far closer to six hours than eight hours for this average nightly sleep duration for people. But I think what can kind of perpetuate it is when you ask friends or family how much sleep they got. They just think of when they went to bed, when they got out of bed and they just think, all right, 100% of that was sleep.

Martin Reed:
So that’s probably closer to eight hours because they’re not thinking about the time that they spend in bed reading or the time that they’re spending in bed just talking to their partner or just lying awake waiting to fall asleep. They’re not counting the time they wake up during the night to use the bathroom. They’re not counting the time that they wake maybe shortly before their alarm. So there’s all these little pockets of time that they’re other thinking of, quite rightly, because they’re not thinking about sleep very much. So they just kind of default to, “Oh, about eight hours.” And I think that kind of perpetuates this pressure, this belief that we all need that amount of sleep and it’s really not true. It just leads to this effort to get more sleep, which can really backfire and make sleep more difficult.

Dave Barrie:
Yeah, exactly.

Martin Reed:
So, okay so you found out about the CBT-I techniques. Can you tell us a bit more about the specific techniques that you found that were helpful for you?

Dave Barrie:
The sleep restriction, which I hate the term sleep restriction as I’ve said. It’s bedtime, bed restriction but that works so well. I actually look forward to the times that I could… I fell into the trap of going to bed at the same time as my wife went to bed. So at 10 o’clock I’d go to bed with her and I wasn’t tired and I’d just lie there. Her head would hit the pillow and she’d fall asleep, which would frustrate me no end. You’d listen to her asleep and I’d lay there going, “Okay, I’m going to lie here for another hour before I get to sleep.”

Dave Barrie:
But the sleep restriction like she’d go to bed and then I’d go, “Okay, great. I’m up for another hour now. I can watch TV, a show that she wouldn’t watch. I can watch sport, I could watch movies.” So I really look forward to having that time and it was my own time but then you could… You actually got the feeling of being sleepy again, which I wasn’t getting. So I was getting that feeling of being sleepy but only after lying in bed for two hours and getting frustrated. So I was getting that feeling of being sleepy while watching TV and you’d actually go to bed and feel like, “Oh, I want to get into bed.” You’d associate that feeling of getting into bed was positive, whereas it was negative before. So that, yeah. I actually really liked having that time to myself.

Martin Reed:
Yeah, I hear that a lot. Some people, they get quite concerned with the idea of allotting less time for sleep because they think that spending less time in bed means there’s not that opportunity to get more sleep. But the thing is, is if you just look back on your own experience, you know from your own experience that spending more time in bed isn’t leading to more sleep. But what it is doing is leading to more time awake and that’s not pleasant. Going to bed before you’ve got that strong sense of sleepiness isn’t a pleasant experience. And so you can kind of turn that around. We’re not looking to… Let’s say your average nightly sleep duration is five hours, we’re not saying only spend four hours in bed. We’re not cutting sleep away from you, we’re just taking the wakefulness away. So, it’s-

Dave Barrie:
I use your analogy of like you don’t sit at the dinner table waiting to get hungry, which I think is fantastic.

Martin Reed:
Yeah, absolutely. It’s strange that we feel, I don’t know. I can understand it, the idea that let’s spend more time in bed. We give ourselves that opportunity for sleep. But when we have the idea, that strategy in our minds we can kind of gloss over the fact that it’s never really worked for us in the past. But yet it’s this behavior that we keep on doing in the hope that something will miraculously change. What does help, is just looking at your average nightly sleep duration, maybe just seeing that as your current sleep capability. So let’s say your average nightly sleep duration right now is about five hours, so from there maybe just allot say five and a half hours for sleep.

Martin Reed:
So you’re not taking any sleep away, you’re still giving yourself that half an hour opportunity for a bit more sleep but what you’re really doing is just reducing all that time spent awake and you’re building that sleep drive during the day. So by staying up typically you’ll be staying up a little bit later and so you get that feeling of sleepiness back and so many people are like, “It’s great. I look forward to the evening now.” After a few weeks of trying this and they start to get that feeling of sleepiness back it’s just this big revelation. I hear, “I’d forgotten what it was like to feel sleepy.” And they actually look forward to staying up later exactly as you described. So it was really good to hear you describe it just like that.

Dave Barrie:
Yes, 100%. It was a simple thing but it was such a mind changing thing to take those feelings of negativity and then turn them around and that was such a positive thing just to have that time to myself when I was staying up. But also getting like I was positive to go to bed and I felt so tired. When you’ve got the sleep restriction and your window is pushed back you’re struggling to stay awake and watch TV but when you go to bed you feel like, “Ah, I can relax.” And you just feel so happy and you feel the sheets on your body and you feel the weight of your body on the bed and I was going out within five minutes easily.

Martin Reed:
Oh yeah, I think it’s just like you’ve just described it, it’s just such a big mindset change where you start to look forward to that moment of getting into bed instead of starting to dread it. And I think too another benefit of this is because you’re spending less time awake in bed because you’re more sleepy and you’re not allotting quite so much time for sleep, you spend less time awake in bed so you’re kind of chipping away at that conditioned arousal that we talked about a little bit earlier. So you’re kind of retraining yourself to see the bed as a place for sleep instead of wakefulness. And so that’s another one of these longterm benefits is the bed once again starts to become this strong trigger for sleep and that’s why it’s just so helpful for the longterm.

Dave Barrie:
Yeah, and I talk to a lot of people who don’t have insomnia about, “What do you do?” And as you say they say, “Oh, nothing. I just go to bed and that.” And I tell them about my negative association with sleep and bed and they go, “Why? I love the bed, I love going to sleep.” And it was only when you get that sleep drive and you feel so tired that you do start to appreciate the bed and love the bed again and love to get to bed instead of dreading… You’d feel tired, you feel sleepy but on that walk to bed that feeling of dread would hit you again and you’d start, you’d lie in bed and you’d go, “I’m awake now.” But that was the time that I’d go, “Okay, I need to get out of bed again.” And go and do something positive and get that positive mind frame again and then try again and it would work.

Martin Reed:
Because we’re talking about the front end right now just typically involves staying up later, how did you do on the other side, which is having this consistent out of bed time in the morning? Because that’s often something that people will struggle with just the idea that they have to get out of bed by a certain time even if they’re having a great night of sleep or even if they’re having a terrible night of sleep. Was this something that you struggled with or did you find it quite easy to do that?

Dave Barrie:
Well, I have to get up. I have to go to work and I’ve got young kids so I’ve got to get them ready for school. So having an awake time was not a problem, I’m quite happy with that. The thing that I did struggle with was the getting out of bed at… Like when it was three o’clock in the morning and when I wasn’t tired and getting up and doing something because that to me… I tried that a few times, I didn’t really stick with that. A couple of times I’d get up and start doing things and it was a real struggle for me to get back to sleep after that. And I would find that… Well, the next day my sleep drive would be crazy high and I’d sleep the next night. So it did work in that way but getting out of bed in the morning was not a real problem.

Martin Reed:
Yeah, that technique you just touched upon, getting out of bed when you’re struggling, I think for many of us we can be a little bit almost over-eager to jump out of bed when we’re awake during the night. And sometimes that can make it hard to get the right results from that technique just because… So it’s known as stimulus control and the idea is it’s just another one of these strategies for retraining ourselves to see the bed as a place of sleep instead of wakefulness.

Martin Reed:
So generally speaking, what we do is use the bed only for sleep. So if we’re awake, we get out of bed. But it can be quite tempting as soon as we wake to then suddenly jump out of bed. But what I tend to suggest to people is that it’s okay to wake during the night because everyone does it. Waking during the night is completely normal and it’s a normal part of sleep. So if you wake during the night and if you still feel calm and relaxed, then you might as well stay in bed because the conditions are right for sleep because you’re calm and relaxed.

Martin Reed:
But it’s that moment if you suddenly start to feel really worried, really anxious, really frustrated. You’re tossing and turning and whipping the sheets around, groaning out loud. That’s kind of your prompt to just get out of bed and just do anything that you find relaxing and enjoyable. It’s almost like a distraction from the mind to stop it from just focusing on that frustration and it’s like this mental reset switch. Even if it’s you’re only out of bed for five minutes. And over the longterm, that can just be helpful at just removing that conditioned anxiety like as soon as you wake up and spending all that time frustrated. You don’t allow yourself to reinforce it because instead what you’re doing is just getting out of bed when you feel anxious and worried and frustrated for a few minutes or for 20 minutes. But some people will watch a TV show like an episode of Friends or something and then return to bed.

Martin Reed:
But that is one of the strategies that isn’t really intended to help improve your sleep that night, that’s more of one of these longterm strategies just over time to help you relearn and see the bed as a place for sleep. But I think it is easy for people just in their enthusiasm to get results quick. As soon as they wake they’ll just kind of jump out of bed, which isn’t always that helpful. Sometimes if just recognizing it’s okay to wake up during the night and it’s certainly okay to stay in bed if you’re calm and relaxed because that means the conditions are still right for you to fall back to sleep.

Dave Barrie:
Yeah, well I found that I had the sleep maintenance insomnia mainly, which was waking in the early hours of the morning. But it was the sleep restrictions of having my bedtime later which cleared that up as well because the sleep drive was so large when I went to bed that I would wake at 3:00 but I’d get back to sleep pretty much straight away because I was still so tired. Whereas before I’d go to bed at 10 o’clock and I’d wake at 3:00 and that was it, I’d feel wide awake. My brain would start ticking and I’d get anxious and that was it. I’d just be lying in bed or get out of bed and do something but I very rarely get back to sleep.

Martin Reed:
Yeah, and I’m really glad that you said that because I get a lot of people that tell me, “Well, this technique, this allotting less time of time for sleep… I can understand how it’s going to help me fall asleep and improve my sleep there because I’m going to be sleepier but I don’t understand how it’s going to help me with those nighttime awakenings with waking before my alarm. How is that going to help me? I don’t understand.” And so it’s interesting that you found, that you described, that you found it really helpful. Why do you think that was? Do you think it was because when you woke during the night you would just still have a higher level of sleepiness? Or do you think there was something else to explain why you found it so helpful?

Dave Barrie:
No, I think that I did, I woke during the night but I was still sleepy like when I had the sleep restriction. But when I didn’t have the sleep restriction, I’d gone to bed early and then I’d woken up and my body’s just sort of turned on and my mind turned on and I started feeling anxious and I looked at the clock, I clock watched and it just escalated things so that I wasn’t getting back to sleep. But when I shifted that time, I was just so tired, so exhausted that I just went pretty much straight back to sleep. I still have times where I will be awake but the norm now is that I get back to sleep.

Martin Reed:
Sometimes I get people say to me, “Just this idea of having less time available for sleep gives me anxiety and makes me feel worried.” Or someone will say, “Oh, I tried this for a few days, I tried it for a week or two weeks but I just found that I was paying more attention to sleep. I felt more anxious because I knew I had less time available to sleep.” Is that something that you dealt with or did you just kind of go all-in without much thought or concern about that?

Dave Barrie:
Yeah, I think with the sleep diary it made me think too much about it. I was thinking too much about the sleep and I was thinking all day about it and it was just consuming my thoughts. It was only when you start to not… For me, it made a huge difference not clock watching. It made me switch off my mind a lot more and I can think about other things instead of… I look at that clock and all the negative thoughts flood back and you can’t get them out of your head and you start thinking, “Okay, this not productive.” But at three o’clock in the morning, it’s like things are so much bigger than in the light of day they’re so insignificant. But it could just be some little thing that my brain would start ticking and I just couldn’t get it out of my head and I couldn’t switch off and get back to sleep.

Martin Reed:
Yeah, and I think that is really common too. All these thoughts that we have during the night, they do seem so much bigger when we have them during the night. If we have a thought at 3:00 in the morning our reaction to it is often very different to what our reaction would be at say 3:00 in the afternoon. And I think a lot of that is just due to we’re just not at our best at 3:00 in the morning, which sounds obvious to say. But when we have these thoughts at 3:00 in the morning, first of all, they can seem 100% true. We could have a thought that says something like, “It’s going to be impossible to get through the day tomorrow because I’m awake at 3:00 in the morning.”

Martin Reed:
But if you have that thought at 3:00 in the afternoon or just reflect back on it, well, look you are getting through the day. Maybe the day’s a bit more difficult but maybe you’re having a good day, maybe there’s a few good moments. You can kind of chip away at those thoughts in the cold light of day but when you have them at night they can just seem deadly accurate and deadly serious and this really makes it harder for you to just calm your mind down during the night.

Dave Barrie:
Yeah, definitely.

Martin Reed:
So right now we’re kind of painting this picture that sleep restriction is kind of this magic pill. You go to bed later one night and suddenly your insomnia is cured. But I think it’s important to be realistic so people have the right expectations here because it often takes a while for these CBT-I techniques of which sleep restriction is one to work. So can you tell us how long it took for you implementing sleep restriction before you kind of noticed those results and how long it took you to get that confidence back and think and worry less about sleep?

Dave Barrie:
Yeah, well I did the sleep diary. I think you recommended do it for a month. So I did it for a month and I could see that my sleep was bad. I could see some nights were better than others and I thought, “Oh, I’ll do this again.” And I printed out the sleep diary again and I did it for another month. And things started to get better but it wasn’t until I didn’t clock watch, I was watching the clock too much, but after that. So it was probably about two months in but I was doing the sleep restriction and I was enjoying it more. I was enjoying that time where I’d stay up and I’d go to bed sleepy and I’d sleep a lot better. I realized that I was getting a lot more sleep when I wasn’t thinking about it as much.

Dave Barrie:
When I had the sleep diary, it would make me think and I’d go, “Look, okay. Now, this is 15 minutes, I’ve got to put 15 minutes in the sleep diary. It’s taking me half an hour to get sleep.” I was thinking about it too much, whereas when I just basically stayed up later and got that sleep drive kicking in and went to bed, I wasn’t thinking about it as much. It’s when I was thinking about it, it was making me anxious and when I took that anxiousness out of it and just went, “Okay, let’s just try this without actually documenting everything.” And it kicked in and then it started working.

Dave Barrie:
So it was probably about two months of doing the sleep diary and then within two weeks after that of just restricting my bedtime, where I found it made a massive difference. That was a game-changer for me, that really helped me sleep. And I really… I can feel that feeling of sleepiness now so I can recognize that, whereas I couldn’t recognize that before.

Martin Reed:
Yeah, I said this to you before when I was preparing for this episode, I remembered that email that I got from you about four weeks after we first connected together and you said that after that four weeks you are finding that you’re just falling asleep so much faster. And that your wife actually said that you were starting to fall asleep faster than her and that’s something that never used to happen.

Martin Reed:
Then a little bit later after that I remember that email when you just said to me, “I got like six hours of solid uninterrupted sleep.” I think it’s just important to emphasize that it does take time and you’ve really got to be consistent with it. It’s so easy because we’re so desperate to make these improvements really quickly we can almost in a way put pressure on ourselves to get these results. So we’re really self-monitoring, which actually makes progress more difficult.

Martin Reed:
But it is so important to recognize that it does take time just like it took time for the insomnia to become entrenched, it kind of takes time to pick it apart. So I think that’s really important that you yourself recognize it was about a two month long process. It wasn’t something that happened in a week or two, it was closer to eight weeks than eight days.

Dave Barrie:
Yeah, well I’ve had this bad habit for over two years. So to take two months to break is expected.

Martin Reed:
Yep, absolutely. So what’s your sleep looking like now? What is a typical night look like for you?

Dave Barrie:
Well, it’s funny that you say before that I was feeling great after having six hours, I had six hours of uninterrupted sleep. Now, I’m thinking that’s one of my worst sleep’s is six hours. I’ll probably sleep between six and seven hours typically a night. And yeah, I feel great after having… Seven hours is amazing. But it’s not quantity of sleep, it’s quality of sleep. I can feel better when I’ve had a really good quality sleep.

Dave Barrie:
It’s weird the way your mind works that if you tell yourself you’ve had a good night’s sleep, you can get on with the day just fine because if you have a bad night’s sleep… My wife stopped asking me the question, “How’d you sleep?” because I’d say, “Horrible.” She’d just wait for me to say if I had a good night’s sleep or not. But I feel even if I have six hours sleep, which is one of my worst night’s sleep now, if I tell myself, “Oh, yeah. No, it’s okay. I’ve done this before. I can go to the gym and I can still workout and have a good day, have a productive day.” And I know that if I’ve had a bad night’s sleep that night that my sleep drive is going to build up so much that I’m going to sleep, there’s no two ways about it, that’s going to happen. So it puts my mind at ease.

Martin Reed:
Yeah, I think that’s another one of the benefits of the bedtime restriction, the sleep restriction, is that it does consolidate sleep. Once your body learns that it’s only got this very specific window in which it has that opportunity to sleep, you do tend to spend less time awake during the night. And that’s consolidated sleep, which is generally better quality sleep and that has far more of an effect on how you feel during the day than quantity alone.

Martin Reed:
It’s like I have clients that I work with and they would let’s say get seven hours of broken, interrupted sleep where they’re in and out of sleep all night but they estimate that they get seven hours of sleep. Then when we implement the sleep restriction, start allotting less time for sleep, they might get less sleep in the short term like let’s say six hours of sleep, five and a half hours of sleep but they notice how much better they feel during the day even though they’re technically getting less sleep. Just because that sleep is so much more consolidated, there’s less of that wakefulness, there’s less of that in and out of sleep. You hear some people say, “I just feel like I’m getting so much light sleep and it’s not really restorative.” And I think that’s one area they can really help with.

Dave Barrie:
Yeah, definitely, definitely.

Martin Reed:
How did you get to the process of extending out your sleep window as you noticed that your sleep was improving and you were spending more time asleep? Did you have a specific technique or a method to just expanding out that amount of time you allowed yourself to sleep?

Dave Barrie:
No, I just sort of winged it. I kept pushing it back because I was keeping the sleep diary and it was showing that I was having poor sleep. So I kept pushing it back and I was getting so tired that I could feel that feeling of being tired. So I’d sort of… I’d push it back until 12 o’clock at night and then I kept bringing it forward. And when I felt that I was tired, I’d go to bed.

Dave Barrie:
Internally I could recognize that this is a good opportunity for me to go to bed, I could feel tired. I’d be staying up and expecting to stay up for two hours. I’d watch a movie and I’d go, “I feel exhausted now, I’m going to bed because I know that my body is ready for sleep. It’s the best opportunity.” I would find sometimes that I would try to push through that and then I would start getting anxious again and then I wouldn’t sleep. So I know that that was the time to go to bed. And I’d go to bed and I’d fall asleep pretty much instantaneously.

Martin Reed:
Yeah, I think that’s really interesting the way you said that just because once you start to notice the benefits, i.e. you are noticing that sleepiness occurring in the evening, then you just basically based it on that. So, if you felt that you were capable of getting more sleep, then you would just allow yourself to go bed a little bit earlier and then see what happened. Then if you’re still doing well, not spending that much time awake during the night, again you let yourself go to be a little bit earlier. Because you should just become more aware of your own sense of sleepiness because you really kind of take the clock out of that equation and just go by your own levels of sleepiness.

Martin Reed:
Did you notice any times that maybe you expanded it out too quickly and that you kind of went back to spending a lot of time awake during the night? Did you have any setbacks like that along the way?

Dave Barrie:
No, I would have a set bedtime that I would try to get up to but if I felt sleepy before then I would go to bed and I would pretty much sleep well. I wasn’t getting that wakefulness at night. If I felt that I was really tired, if I pushed it, I’d get overtired and I did get to bed and I’d feel anxious. But I pretty much felt that once I was tired and went to bed that the sleep maintenance insomnia that I had would pretty much disappear.

Martin Reed:
Yeah, one of the questions I was planning on asking you was whether you’re still implementing the CBT-I techniques but I think you’ve kind of already answered that because you’ve just explained that you just use your sleepiness cues, your own cues for sleepiness now to know when it’s time to go to bed. But I think the real beauty of these CBT-I techniques is because that’s kind of where we want you to get to. We want you to get to this stage where you’re not really analyzing sleep that much anymore, you’re not really thinking about sleep. You’re just kind of going to bed when you feel sleepy but you’ve always got them with you to fall back on. So if you go through this period of a week or two where you’re really struggling you know that you can just kind of pull all these techniques back out of your back pocket and just implement them again to help get your sleep back on track.

Dave Barrie:
And yeah, that’s what I do. I use those CBT-I techniques but I don’t… I’m not going, “Okay, no, I can’t go to bed until 11:30.” Or go, “Okay, now I can’t go to bed until I’m feeling this tired.” And when I do go to bed I do sleep.

Martin Reed:
All right, Dave. So I really appreciate how much time you’ve shared with us today. I’ve got one last question for you, which is this. If someone with chronic insomnia is listening and feels as though they’ve tried everything, they’re beyond help, and they can’t do anything to improve their sleep, what would you tell them?

Dave Barrie:
I would definitely say look up your website, look up Insomnia Coach. The techniques were a game-changer for me. The sleep restriction was amazing. The sleep restriction and don’t look at the clock. The clock is the enemy of sleep.

Martin Reed:
All right, Dave, thanks again for sharing your time with us today. I think a lot of people are going to find this discussion really helpful. I think they’re going to identify with so much of what you’ve said and the idea behind all of these podcast episodes is that if people can recognize their experience in yours and see that you managed to get better, get your sleep back on track and get to that point where you don’t really think about sleep anymore, then they can too. And I think that that’s very reassuring and, hopefully, motivating for people to implement these CBT-I techniques or maybe revisit them if they’ve tried them before in the past. So thank you so much for taking the time out of your day to come on.

Dave Barrie:
You’re very welcome. Thank you, Martin.

Martin Reed:
Thanks for listening to The Insomnia Coach Podcast. If you’re ready to implement evidence-based cognitive and behavioral techniques to improve your sleep but think you might need some additional support and guidance, I would love to help. There are two ways we can work together. First, you can get my online coaching course. This is the most popular option. My course combines sleep education with individualized coaching and is guaranteed to improve your sleep. You will learn new ways of thinking about sleep and implement better sleep habits over a period of eight weeks. This gives you time to build sleep confidence and notice results without feeling overwhelmed. You can get the course and start right now at insomniacoach.com/online.

Martin Reed:
I also offer a phone coaching package where we start with a one hour call. This can be voice only or video, your choice, and we come up with an initial two-week plan that will have you implementing cognitive and behavioral techniques that will lead to long term improvements in your sleep. You get unlimited email-based support and guidance for two weeks after the call along with a half-hour follow-up call at the end of the two weeks. You can book the phone coaching package at insomniacoach.com/phone.

Martin Reed:
I hope you enjoyed this episode of the Insomnia Coach Podcast. I’m Martin Reed, and as always, I’d like to leave you with this important reminder — you can sleep.